Organization · NPI-2

9th Street Dental Center PC

Dentist, General Practice · Philadelphia, PA

NPI number1134584899
StatusActive
Last updated in NPPESDec 23, 2015

Details

NPI
1134584899
Entity type
Organization (NPI-2)
Legal business name
9th Street Dental Center PC
Organization subpart
No
Enumeration date
Dec 23, 2015
Last updated
Dec 23, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeDS-030933-LPAYes

Practice location

821 S 9th St
Philadelphia, PA 19147-2822

Phone 215-629-0599 · Fax 215-629-0596

Mailing address

821 S 9th St
Philadelphia, PA 19147-2822

Phone 215-629-0599 · Fax 215-629-0596

Authorized official

Terrence T Fan
Owner
2156290596

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